Kenalog 0.1% Cream 15gm
It is used to treat skin rashes and other skin irritation.
Drug Class
Corticosteroid, topical
Pharmacologic Class
Glucocorticoid receptor agonist
Pregnancy Category
Category C
FDA Approved
Aug 1958
DEA Schedule
Not Controlled
Overview
What is this medicine?
Kenalog 0.1% Cream contains triamcinolone, a type of medicine called a corticosteroid. It works by reducing inflammation, redness, and itching caused by various skin conditions like eczema, psoriasis, and dermatitis. It helps to calm down your skin's overactive immune response.
How to Use This Medicine
Proper Use of This Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided. Use this medication only as directed, and continue to use it even if your symptoms improve.
Application Instructions
Apply this medication only to your skin, avoiding the mouth, nose, and eyes, as it may cause burning.
Wash your hands before and after applying the medication, unless your hand is the treated area.
Clean and dry the affected area before applying a thin layer of the medication, gently rubbing it in.
Avoid applying the medication to the face, underarms, or groin area unless your doctor instructs you to do so.
Do not use bandages, dressings, or tight-fitting diapers or plastic pants on the treated area, as this may increase the amount of medication absorbed into the body.
Do not use this medication to treat diaper rash.
Avoid applying the medication to cuts, scrapes, or damaged skin.
Storage and Disposal
Store this medication at room temperature, avoiding freezing.
Keep all medications in a safe place, out of the reach of children and pets.
Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so by your pharmacist. Check with your pharmacist for guidance on disposal, and consider participating in local drug take-back programs.
Missed Dose Instructions
If you miss a dose, apply it as soon as you remember.
If it is close to the time for your next dose, skip the missed dose and resume your regular schedule.
* Do not apply two doses at the same time or use extra doses.
To use this medication correctly, follow your doctor's instructions and read all the information provided. Use this medication only as directed, and continue to use it even if your symptoms improve.
Application Instructions
Apply this medication only to your skin, avoiding the mouth, nose, and eyes, as it may cause burning.
Wash your hands before and after applying the medication, unless your hand is the treated area.
Clean and dry the affected area before applying a thin layer of the medication, gently rubbing it in.
Avoid applying the medication to the face, underarms, or groin area unless your doctor instructs you to do so.
Do not use bandages, dressings, or tight-fitting diapers or plastic pants on the treated area, as this may increase the amount of medication absorbed into the body.
Do not use this medication to treat diaper rash.
Avoid applying the medication to cuts, scrapes, or damaged skin.
Storage and Disposal
Store this medication at room temperature, avoiding freezing.
Keep all medications in a safe place, out of the reach of children and pets.
Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so by your pharmacist. Check with your pharmacist for guidance on disposal, and consider participating in local drug take-back programs.
Missed Dose Instructions
If you miss a dose, apply it as soon as you remember.
If it is close to the time for your next dose, skip the missed dose and resume your regular schedule.
* Do not apply two doses at the same time or use extra doses.
Lifestyle & Tips
- Wash your hands before and after applying the cream.
- Apply a thin layer of cream to the affected skin area, gently rubbing it in until it disappears.
- Do not use more than directed or for longer than prescribed.
- Avoid applying to the face, groin, or armpits unless specifically instructed by your doctor.
- Do not cover the treated area with bandages or tight dressings unless your doctor tells you to, as this can increase absorption and side effects.
- Avoid contact with eyes, nose, and mouth. If contact occurs, rinse thoroughly with water.
- Keep out of reach of children.
Available Forms & Alternatives
Available Strengths:
Generic Alternatives:
Dosing & Administration
Adult Dosing
Standard Dose:
Apply a thin film to the affected area 2 to 4 times daily.
Dose Range:
2 - 4 mg
Condition-Specific Dosing:
occlusiveDressing:
Not recommended unless directed by physician due to increased systemic absorption risk.
duration:
Limit treatment to 2 weeks for most conditions; up to 4 weeks for severe psoriasis or recalcitrant eczema.
Pediatric Dosing
Neonatal:
Not established
Infant:
Apply a thin film to the affected area 1 to 2 times daily. Use with caution; increased risk of systemic absorption and HPA axis suppression due to larger skin surface area to body weight ratio.
Child:
Apply a thin film to the affected area 1 to 2 times daily. Use with caution; increased risk of systemic absorption and HPA axis suppression.
Adolescent:
Apply a thin film to the affected area 2 to 4 times daily. Use with caution; increased risk of systemic absorption and HPA axis suppression.
Dose Adjustments
Renal Impairment:
Mild:
No adjustment needed for topical application.
Moderate:
No adjustment needed for topical application.
Severe:
No adjustment needed for topical application.
Dialysis:
No adjustment needed for topical application.
Hepatic Impairment:
Mild:
No adjustment needed for topical application.
Moderate:
No adjustment needed for topical application.
Severe:
No adjustment needed for topical application.
Pharmacology
Mechanism of Action
Triamcinolone acetonide is a synthetic corticosteroid that possesses anti-inflammatory, antipruritic, and vasoconstrictive properties. It acts by inducing phospholipase A2 inhibitory proteins, lipocortins, which control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor, arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.
Pharmacokinetics
Absorption:
Bioavailability:
Minimal systemic absorption; varies with skin integrity, vehicle, and use of occlusive dressings. Increased absorption with inflamed skin, large surface areas, or prolonged use.
Tmax:
Not well-defined for topical application due to minimal systemic absorption.
FoodEffect:
Not applicable for topical application.
Distribution:
Vd:
Not available for topical application due to minimal systemic absorption.
ProteinBinding:
Not available for topical application due to minimal systemic absorption.
CnssPenetration:
Limited
Elimination:
HalfLife:
Not well-defined for topical application due to minimal systemic absorption.
Clearance:
Not well-defined for topical application due to minimal systemic absorption.
ExcretionRoute:
Primarily renal (if systemically absorbed), but minimal for topical.
Unchanged:
Not available for topical application.
Pharmacodynamics
OnsetOfAction:
Within hours to days for symptomatic relief.
PeakEffect:
Within days of consistent application.
DurationOfAction:
Varies with individual and condition, generally maintained with regular application.
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor immediately or seek emergency medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of high blood sugar, including:
+ Confusion
+ Feeling sleepy
+ Unusual thirst or hunger
+ Passing urine more often
+ Flushing
+ Fast breathing
+ Breath that smells like fruit
Signs of a weak adrenal gland, such as:
+ Severe upset stomach or vomiting
+ Severe dizziness or fainting
+ Muscle weakness
+ Feeling very tired
+ Mood changes
+ Decreased appetite
+ Weight loss
Signs of Cushing's syndrome, including:
+ Weight gain in the upper back or belly
+ Moon face
+ Severe headache
+ Slow healing
Irritation at the site where the medication was applied
Skin changes, such as:
+ Pimples
+ Stretch marks
+ Slow healing
+ Hair growth
Change in skin color
Thinning of the skin
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only have mild ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms, contact your doctor for advice:
Burning
Itching
* Dry skin
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor immediately or seek emergency medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of high blood sugar, including:
+ Confusion
+ Feeling sleepy
+ Unusual thirst or hunger
+ Passing urine more often
+ Flushing
+ Fast breathing
+ Breath that smells like fruit
Signs of a weak adrenal gland, such as:
+ Severe upset stomach or vomiting
+ Severe dizziness or fainting
+ Muscle weakness
+ Feeling very tired
+ Mood changes
+ Decreased appetite
+ Weight loss
Signs of Cushing's syndrome, including:
+ Weight gain in the upper back or belly
+ Moon face
+ Severe headache
+ Slow healing
Irritation at the site where the medication was applied
Skin changes, such as:
+ Pimples
+ Stretch marks
+ Slow healing
+ Hair growth
Change in skin color
Thinning of the skin
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only have mild ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms, contact your doctor for advice:
Burning
Itching
* Dry skin
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Signs of skin infection (e.g., pus, spreading redness, fever)
- Worsening of your skin condition
- Severe burning, itching, or irritation after application
- Thinning of the skin, easy bruising, or stretch marks in the treated area
- Unusual hair growth in the treated area
- Acne-like breakouts
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, any of its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This information will help your doctor assess potential interactions between this medication and other substances you are taking.
* Any health problems you have, as they may affect the safety and efficacy of this medication.
Remember, this is not an exhaustive list of potential interactions. To ensure your safety, it is crucial to consult with your doctor and pharmacist about all your medications and health conditions. Never start, stop, or change the dose of any medication without first discussing it with your doctor.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, any of its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This information will help your doctor assess potential interactions between this medication and other substances you are taking.
* Any health problems you have, as they may affect the safety and efficacy of this medication.
Remember, this is not an exhaustive list of potential interactions. To ensure your safety, it is crucial to consult with your doctor and pharmacist about all your medications and health conditions. Never start, stop, or change the dose of any medication without first discussing it with your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Adhere to the prescribed treatment duration, and do not use this drug for an extended period beyond what your doctor has recommended.
Before using any other medications or products on your skin, including soaps, consult with your doctor to ensure safe and effective treatment. Exercise caution when applying this medication to a large area of skin, and discuss this with your doctor if necessary.
Using this medication too frequently can exacerbate your skin condition. If the patient is a child, use this medication with caution, as the risk of certain side effects may be higher in children. In some cases, this drug may affect growth in children and teenagers, and regular growth checks may be necessary. Consult with your doctor to discuss this potential risk.
If you are pregnant, planning to become pregnant, or are breastfeeding, inform your doctor. It is crucial to discuss the benefits and risks of this medication to both you and your baby to make an informed decision.
Before using any other medications or products on your skin, including soaps, consult with your doctor to ensure safe and effective treatment. Exercise caution when applying this medication to a large area of skin, and discuss this with your doctor if necessary.
Using this medication too frequently can exacerbate your skin condition. If the patient is a child, use this medication with caution, as the risk of certain side effects may be higher in children. In some cases, this drug may affect growth in children and teenagers, and regular growth checks may be necessary. Consult with your doctor to discuss this potential risk.
If you are pregnant, planning to become pregnant, or are breastfeeding, inform your doctor. It is crucial to discuss the benefits and risks of this medication to both you and your baby to make an informed decision.
Overdose Information
Overdose Symptoms:
- While rare with topical use, prolonged or extensive use, especially in children or with occlusive dressings, can lead to systemic effects such as Cushing's syndrome (e.g., moon face, buffalo hump, weight gain), hyperglycemia, or adrenal suppression.
What to Do:
If you suspect an overdose or significant systemic absorption, contact your doctor or poison control center immediately (e.g., 1-800-222-1222). Treatment is supportive and may involve gradual withdrawal of the medication.
Drug Interactions
Monitoring
Baseline Monitoring
Skin condition assessment
Rationale: To establish baseline severity of dermatosis and identify any signs of infection.
Timing: Prior to initiation of therapy.
Routine Monitoring
Efficacy (reduction in inflammation, pruritus)
Frequency: Weekly or as clinically indicated.
Target: Improvement in symptoms and skin appearance.
Action Threshold: Lack of improvement or worsening symptoms after 1-2 weeks may require re-evaluation of diagnosis or treatment.
Local adverse effects (skin atrophy, striae, telangiectasias, folliculitis)
Frequency: At each follow-up visit, especially with prolonged use.
Target: Absence of adverse effects.
Action Threshold: Development of adverse effects warrants reduction in frequency, potency, or discontinuation.
Signs of HPA axis suppression (rare with topical use)
Frequency: Consider for extensive, prolonged use, especially in children or with occlusive dressings (e.g., plasma cortisol levels).
Target: Normal cortisol levels.
Action Threshold: Suppression requires gradual withdrawal of the drug.
Symptom Monitoring
- Worsening redness
- Increased itching or burning
- Development of new skin lesions
- Signs of skin infection (pus, fever, increased pain)
- Thinning of skin
- Stretch marks (striae)
- Easy bruising
Special Patient Groups
Pregnancy
Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Avoid large areas, prolonged use, or occlusive dressings.
Trimester-Specific Risks:
First Trimester:
Potential for teratogenicity, though data for topical corticosteroids is limited and generally low risk.
Second Trimester:
Risk of fetal growth restriction or adrenal suppression with high doses/prolonged use.
Third Trimester:
Risk of fetal growth restriction or adrenal suppression with high doses/prolonged use.
Lactation
Use with caution. It is not known whether topical triamcinolone is excreted in human milk. Systemic absorption is minimal, but caution is advised. Avoid applying to the breast area to prevent infant ingestion.
Infant Risk:
Low risk with appropriate use, but monitor for potential adverse effects if significant systemic absorption occurs in the mother.
Pediatric Use
Children are more susceptible to systemic adverse effects (e.g., HPA axis suppression, Cushing's syndrome, growth retardation) due to a larger skin surface area to body weight ratio. Use the least potent effective dose for the shortest duration possible. Avoid occlusive dressings.
Geriatric Use
No specific dosage adjustments are generally needed. However, elderly patients may have thinner skin, which could potentially increase systemic absorption. Monitor for skin atrophy and other local adverse effects.
Clinical Information
Clinical Pearls
- Triamcinolone 0.1% is a medium-potency topical corticosteroid, suitable for various inflammatory dermatoses.
- Educate patients on proper application technique: thin layer, gentle rubbing, and avoiding overuse.
- Warn patients about the risk of skin atrophy, especially on the face, intertriginous areas, and with prolonged use.
- For conditions requiring long-term management, consider intermittent therapy or stepping down to lower potency corticosteroids or non-steroidal alternatives.
- Always rule out fungal or bacterial infections before initiating corticosteroid therapy, as corticosteroids can worsen these conditions.
Alternative Therapies
- Other topical corticosteroids (e.g., hydrocortisone, fluocinolone, clobetasol depending on potency needed)
- Topical calcineurin inhibitors (e.g., tacrolimus, pimecrolimus for eczema)
- Topical phosphodiesterase-4 (PDE4) inhibitors (e.g., crisaborole for eczema)
- Emollients and moisturizers (for dry skin conditions)
- Antihistamines (for pruritus)
- Systemic therapies (for severe or widespread conditions)
Cost & Coverage
Average Cost:
$15 - $40 per 15gm tube (generic)
Generic Available:
Yes
Insurance Coverage:
Tier 1 or Tier 2 (for generic)
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about this medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide details about the medication, including the amount taken and the time it happened, to facilitate prompt and effective treatment.